Problems with Adults Following Ultrasound-Guided Percutaneous Nephrostomy. A retrospective study

Original Article

Abstract

Background: Obstructive uropathy, which represents 10% of acute renal failure, calls for effective remedies. Percutaneous nephrostomy (PCN) is increasingly used in the treatment of obstructions in the renal collecting system. This Institute of Kidney Diseases study from the city of Peshawar in Pakistan now remedies a lack of knowledge in adult PCN guided by ultrasonography.

Objectives:  to identify suitable candidates for Percutaneous Nephrostomy (PCN), evaluate the success rate of the procedure, and assess the incidence of complications associated with ultrasound-guided PCN. The research seeks to establish clear criteria for patient selection, measure procedural efficacy, and ensure safety by minimizing potential risks.

Study design: A Retrospective Study.

Palace and duration of study. Department of Urology MTI,LRH Peshawar from January 5, 2022, to December 31, 2023

Methods: We did a retrospective analysis in the Institute of Kidney Diseases, Peshawar, of those persons who had an ultrasound-guided PCN for obstructive uropathy from January 5, 2022, to December 31, 2023. Data were from the Department of Urology registrations and HIS Records. Subjects must be over 16 years old. Exclusion criteria were incomplete records, pregnancy, and non-obstructive uropathy indications: those things should not have made it into the sample! IBM SPSS was used to do data analysis.

Results: There were 851 patients included in the study; the average Age was 38.50 ± 14.78 years. Successful PCN installs were achieved in 96.1% of cases; 67 patients had to go through multiple trials. Complications occurred in 18.9% of cases, mostly mild (17.6%) and occasionally severe (1%) headaches. The most common complications were macroscopic hematuria (6.9%), PCN dislodgment (1.9%), and block of the tube (1.8%). Statistical analysis showed associations between complications and demographic factors, such as Age, gender, and number of attempts.

Conclusion: Ultrasound-guided percutaneous nephrostomy (PCN) is safe and effective in the treatment of obstructive uropathy. These findings contribute to improving treatment protocols and procedural guidelines at the Institute of Kidney Diseases, Peshawar, with urinary stones as the main aetiology.

Keywords: Percutaneous Nephrostomy, Complications, Obstructive Uropathy